towards a health ethics policy framework to analyse user fee exemptions renaud boulanger, matthew...

Towards a health ethics policy framework to analyse user fee exemptions

Renaud Boulanger, Matthew Hunt, Valéry Ridde

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• Policies are statements of decisions and actions– Often about government activities, but not exclusively

• Policy analysis looks at the initiation, development, and implementation of policies– Methods: statistical techniques, focus groups, case

studies, document analysis– In North America, health policy analysis expanded

following the increased government role in health care (1960s) 3

Policy & analysis

4Ethics?

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1. Set of ethical principles/theories germane to public policy2. Understanding of how the explicit use of ethical concerns

affects policy dynamics3. Approaches for ethical analyses that can contribute to

policy making4. Indicators of robust, high quality ethical analysis

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Limitations of available tools

Development

Action

Evaluation

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Limitations of available tools

©2014 tagxedo.com

nt = 73np = 15

Substantive

Proceduralvs.

Values

Principles&

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1. Adaptable

2. Recognise that policies have life cycles

3. Use (inclusive) empirical data

4. Foster constructive criticism

5. Easy to use

6. Transparent

Frameworks’ desirable characteristics

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Formulation

To what extent did the deliberation process respect [procedural value/principle]?

Implementation

To what extent does the implementation embody

[value/principle]?

Outcomes

Does the policy increase [substantive

value/principle]?

Emergence

Did the agenda setting discourse reflect

[substantive value/principle]?

Evaluator’s reflexivity

Proposal

1.Adaptable

2.Recognise that policies have life cycles

3.Use (inclusive) empirical data

4.Foster constructive criticism

5.Easy to use

6.Transparent

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Outcomes

Does the policy increase fairness?

Proposal

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Next steps

1. Expand the literature review– Continue identifying values and principles – Catalogue tools for various values and principles

2. Apply to case studies– Institutional policies– National policies (e.g.: user fee exemptions)

3. Develop indicators of quality

Check http://www.equitesante.org/home/ for updates

• Funding support

Acknowledgements

For more information: renaud.boulanger@mail.mcgill.ca